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Chubb Insurance Company Of Australia LimitedABN 69 003 710 647 AFSL No 239778www.chubbinsurance.com.au

Group Personal Accident & Sickness InsuranceProduct Disclosure Statement (PDS) & Policy Wording

Version 1Issued: 1 June 2014

Group Personal Accident & Sickness Insurance PDS and Policy Wording 14GPASPDSPWv1

Chubb Insurance Company of Australia Limited 2014 © Copyright All Rights Reserved.

Table of Contents

Product Disclosure Statement (PDS) .......................................................................................................................................3About Our Group Personal Accident & Sickness Insurance .........................................................................................................4Insurer ..........................................................................................................................................................................................4What is the Product Disclosure Statement? .................................................................................................................................4The Meaning of Certain Words .....................................................................................................................................................4Updating Our PDS ........................................................................................................................................................................4Group Insurance Policies .............................................................................................................................................................4Significant Risks and Benefits of the Group Personal Accident & Sickness Insurance Policy .....................................................4Operation of Cover .......................................................................................................................................................................5Policy Excesses............................................................................................................................................................................5Premium .......................................................................................................................................................................................5Non-Payment of Premium ............................................................................................................................................................5A Claim May be Refused ..............................................................................................................................................................5Cancelling Your Policy Before it Expires.......................................................................................................................................5Confirmation of Transactions ........................................................................................................................................................6Duty of Disclosure – What We Need You to Tell Us .....................................................................................................................6Privacy ..........................................................................................................................................................................................6Financial Claims Scheme .............................................................................................................................................................7The General Insurance Code of Practice .....................................................................................................................................7How to Make a Claim ...................................................................................................................................................................7Cooling Off Period ........................................................................................................................................................................7Dispute Resolution .......................................................................................................................................................................7Insurance Council of Australia ......................................................................................................................................................8Additional Information ...................................................................................................................................................................8About the Insurer ..........................................................................................................................................................................8

Policy Wording ...........................................................................................................................................................................9Group Personal Accident & Sickness Insurance Coverage........................................................................................................10General Definitions .....................................................................................................................................................................10Personal Accident & Sickness Cover .........................................................................................................................................13Table of Events ...........................................................................................................................................................................13Lifestyle Protection Benefits .......................................................................................................................................................17Corporate Protection Benefits ....................................................................................................................................................20General Conditions Applicable to this Policy ..............................................................................................................................21General Provisions Applicable to this Policy...............................................................................................................................22General Exclusions Applicable to this Policy ..............................................................................................................................24How to Make a Claim .................................................................................................................................................................25Notice of Claim ...........................................................................................................................................................................25Commitment to Service ..............................................................................................................................................................25

Product Disclosure Statement (PDS)



About Our Group Personal Accident & Sickness InsuranceInsurer

The policy is underwritten and issued by Chubb Insurance Company of Australia Limited ABN 69 003 710 647 AFSL 239778 (Chubb also referred to as us, we or our). Chubb is a member of the Chubb Group of Companies whose operating business commenced in 1882.

Please read the Product Disclosure Statement (PDS) and the policy carefully and do not hesitate to contact us should you wish to comment on any aspect of our service to you.

What is the Product Disclosure Statement?

The policy is underwritten and issued by Chubb. The PDS provides general information only, and should be read in conjunction with the attached policy wording and any endorsements attaching to it. The PDS and policy contain important information that you should read carefully before deciding to take out any insurance cover.

The Meaning of Certain Words

Throughout this PDS and in the policy wording, certain words appear in italics. These words have special meaning and are included in the General Definitions and in the Definitions appearing in the individual policy Sections located in this document. Please refer to the Definitions for their meaning.

Paragraph Headings

The paragraph headings used throughout this PDS, the policy wording, and the policy schedule are intended for reference purposes only and do not inform policy interpretation.

Policy Terms and Conditions

The information contained in the PDS is general information only and does not form part of your contract with us. The policy is our legal contract with you and contains the terms, conditions and exclusions relating to the insurance cover to be provided by us.

The PDS and the policy, which includes the policy schedule, are important documents, so please check them carefully for the coverage they provide and retain them safely for future reference. Certain types of cover under this insurance require you or an insured person to provide documentary evidence to us where a claim is made (e.g. medical certificates, proof of earnings). You should also keep those documents in a safe place in case we need them to settle a claim.

Should you require any further information about this or any other product, please contact your authorised financial services provider.

Updating Our PDS

We may need to update the information contained in our PDS from time to time (where allowed or required by law). We will issue you with a new PDS or a Supplementary PDS when this happens.

Group Insurance Policies

If you are a corporation or any type of group, association or organisation obtaining this policy for the benefit of your members or employees, you must ensure that a copy of this PDS and the policy is provided to each member or employee in your organisation.

If new members or employees join your organisation you must ensure they are provided with this PDS and the policy when they join.

Significant Risks and Benefits of the Group Personal Accident & Sickness Insurance Policy

This document has been prepared to assist you in understanding the Group Personal Accident & Sickness Insurance provided by this policy and to help you make an informed choice about it. You must decide what cover you need, so please read this PDS, the policy which includes the policy schedule, the Table of Events and the Benefit Amounts, and any other documents that we tell you form part of your policy, carefully. You should be aware of what the policy covers, the limits on cover and the exclusions from cover. There are also conditions of cover with which you must comply; if you do not, we may not have to pay any claim you make.

We may be prohibited by law from providing cover where:

• trade or economic sanctions or other laws or regulations apply to us, our parent company or its ultimate controlling entity; or

• an insured person is eligible for benefits under Medicare or private health insurance laws or regulations in Australia including the Health Insurance Act 1973 (Cth) National Health Act 1953 (Cth), Private Health Insurance Act 2007 (Cth) and Private Health Insurance (Health Insurance Business) Rules 2010 or any successor legislation. Accordingly, you and all insured persons should check their eligibility for cover under this Group Personal Accident & Sickness Insurance policy. They may need to submit claims to Medicare and arrange private health insurance.



Some of the significant benefits of the Group Personal Accident & Sickness policy include:

• cover is available for persons up to seventy-five (75) years of age;

• Personal Accident and Sickness benefits including:

- Accidental Death and Disablement

- Weekly Injury Benefit

- Weekly Sickness Benefit

- Fractured Bones

- Injury Resulting in Surgery undertaken outside Australia

- Sickness Resulting in Surgery undertaken outside Australia

• a range of Lifestyle Protection Benefits and Corporate Protection Benefits as stated in the policy.

Operation of Cover

The cover provided by this policy will only apply during the period of insurance stated in the policy schedule, as limited by the Operation of Cover stated in the policy schedule.

Policy Excesses

If you or an insured person makes a claim under the policy you may be required to pay an excess. This is the amount you must first contribute towards each claim.

For example, if an insured person has cover provided under Part G – Injury Resulting in Loss or Damage to Teeth of the policy and makes a claim for loss of teeth in the amount of one thousand dollars ($1,000) and an excess of fifty dollars ($50) applies, then the insured person will be asked to pay fifty dollars ($50) towards their loss and we will pay nine hundred and fifty dollars ($950).

Premium

All cover is subject to payment of premium. In calculating the premium for the policy we take into account a range of factors including but not limited to:

• age, occupation and previous insurance history; and

• the limits, excesses and/or annual aggregates chosen.

The premium varies depending on the information you give us in relation to the risks to be covered by us. We decide the amount of premium on the basis of our experience and the factors that increase our risk.

The premium also includes amounts that take into account our obligation to pay any relevant compulsory government charges, taxes or levies (e.g. stamp duty) in relation to your policy. These amounts will be set out separately in the policy schedule as part of the total premium payable.

If a claim is made on the policy and the premium is outstanding, we may deduct any outstanding premium from the claim payment. This will not remove or absolve you from the obligation to pay us any remaining or outstanding premium due.

Non-Payment of Premium

You must pay your premium or any additional premium we request from you on time otherwise your policy may not operate. We have the right to cancel your policy for non payment of premium.

If a claim is made on the policy while any premium is outstanding, we reserve the right to treat the policy as never having been in force or agree in our absolute discretion to accept the claim subject to payment of the premium, or deduction of any claim payment from the premium due, or we may deduct any outstanding premium from the claim payment.

A Claim May be Refused

We may refuse to pay or reduce the amount we pay under a claim if you do not comply with the policy conditions, if you do not comply with your Duty of Disclosure, or if you or the insured person makes a fraudulent claim.

Cancelling Your Policy Before it Expires

The policyholder may cancel this policy at any time by notifying us in writing. The cancellation will take effect from 4:00 pm on the day we receive the policyholder’s written notice of cancellation or such time as may be otherwise agreed.

We may cancel the policy or any Part thereof, for any of the reasons set out in Section 60 of the Insurance Contracts Act 1984 (Cth) and in accordance with Section 59 of the Insurance Contracts Act 1984 (Cth).

If the policy is cancelled by either the policyholder or us, we will refund the premium for the policy less a pro-rata proportion of the premium to cover the period for which insurance applied. However we will not refund any premium if we have paid a claim or benefit to you or an insured person under the policy.

Cover in respect to an insured person will end on the earlier of:

1. the date the insured person no longer meets the criteria for an insured person set out in the policy schedule;

2. the end of the period of insurance; or

3. when this policy is cancelled by you at your request or by us pursuant to the Insurance Contracts Act 1984 (Cth).



Cover in respect to an insured person’s spouse or partner and/or dependent child(ren) will end on the earlier of:

1. the date insurance cover in respect of the insured person is terminated in accordance with the above; or

2. the date such spouse or partner and/or dependent child(ren) ceases to be a spouse or partner and/or dependent child(ren) of the insured person.

Confirmation of Transactions

If you wish to confirm that your insurance is in place, and obtain a Certificate of Currency we provide a telephone confirmation service.

To use this service, call us on:

Brisbane (07) 3227 5777

Melbourne (03) 9242 5111

Perth (08) 6211 7777

Sydney (02) 9273 0100

and we will send you written confirmation.

If you do not wish to use our telephone confirmation service but require confirmation of cover, you can request this by writing directly to Chubb at the addresses appearing in the ‘About the Insurer’ section at the end of the PDS.

Duty of Disclosure – What We Need You to Tell Us

Before you enter into a general insurance contract, you have a duty under the Insurance Contracts Act 1984 (Cth) to disclose to the insurer every matter that you know, or could reasonably be expected to know, is relevant to the insurer’s decision on whether to insure you and if so, upon what terms. You have the same duty before we extend, vary or reinstate the insurance. This duty does not require disclosure of any matter that:

• reduces the risk to the insurer;

• is of common knowledge;

• the insurer knows, or in the ordinary course of its business, ought to know; or

• where compliance with this duty is waived by the insurer.

If you fail to comply with this duty of disclosure, we may be entitled to reduce our liability under the contract in respect of a claim or may cancel the contract. If your non-disclosure is fraudulent, we may be entitled to void the contract from its beginning.

PrivacyYour PrivacyIn the course of providing insurance and processing insurance claims, we need to collect personal and sensitive information about persons we insure and persons associated with insured persons. If you do not give us this information, we may not be able to provide insurance or process a claim.

In accordance with the Privacy Act 1988 (Cth), our Privacy Policy statement contains the information required to be given to persons about whom we collect personal and sensitive information.

Our Privacy PolicyOur Privacy Policy statement is readily available on our website. It provides information on how you can make a complaint against us for a breach of the Australian Privacy Principles (“APPs”), or registered APP code(s), if any, that bind us.

Further information on our Privacy Policy can be viewed on our website at: www.chubbinsurance.com.au

Your Access to Your Personal InformationYou can request access to personal and sensitive information that we hold about you. Your rights to access and our rights to refuse access are set out in the Privacy Act 1988 (Cth)

Our Use of Personal InformationWe may at any time use personal information we collect about you for any of the following purposes:

• to provide a quotation or assess a proposal for insurance;

• to provide, amend or renew an insurance policy; or

• to respond to a claim.

Our Disclosure of Personal InformationWe may at any time disclose personal and sensitive information we collect about you to the following types of organisations (some of which may be outside Australia):

• reinsurers;

• external valuers and appraisers;

• loss adjustors, investigators and other organisations retained by us who help us provide our claims service;

• professional advisers, such as accountants and lawyers; and

• other organisations that provide services to us in relation to the provision of insurance.



Financial Claims Scheme

Your policy is a protected policy under the Financial Claims Scheme (FCS), which protects certain insureds and claimants in the event of an insurer becoming insolvent. In the unlikely event of Chubb becoming insolvent you may be entitled to access the FCS, provided you meet the eligibility criteria. More information may be obtained from APRA -www.apra.gov.au or 1300 55 88 49.

The General Insurance Code of Practice

Chubb has adopted the General Insurance Code of Practice (the Code). The Code aims to:

1. promote more informed relations between insurers and their customers;

2. improve consumer confidence in the general insurance industry;

3. provide better mechanisms for the resolution of complaints and disputes between insurers and their customers; and

4. commit insurers and the professionals they rely upon to higher standards of customer service.

For more information please visit the Code of Practice website at www.codeofpractice.com.au or follow the links from the Insurance Council of Australia’s website at www.insurancecouncil.com.au

How to Make a Claim

If you wish to make a claim please contact us directly:

E-mail: [email protected]

Post: PO Box 20336 World Square PO NSW 2002

Full details of what you or the insured person must do for us to consider the claim are provided in the ‘How to Make a Claim’ section of your policy.

Cooling Off Period

You have twenty-one (21) days to consider the information contained in your policy. This is your cooling off period. If you would like, and provided a claim has not been made under your policy, you have the right to cancel your insurance. We will refund in full any premium you have paid.

To exercise this right you must notify us in writing or electronically within twenty-one (21) days from the date your policy takes effect.

Dispute Resolution

The following standards apply to all complaints handling.

1. We will conduct complaints handling in a fair, transparent and timely manner.

2. We will make information about our complaints handling procedures available.

3. We will only ask for and take into account relevant information when deciding on your complaint.

4. You will have access to information about you that we have relied on in assessing your complaint and an opportunity to correct any mistakes or inaccuracies. In special circumstances or where a claim is being or has been investigated, we may decline to release information but we will not do so unreasonably. In these circumstances, we will give you reasons. We will provide our reasons in writing upon request.

5. Where an error or mistake in handling your complaint is identified, we will immediately initiate action to correct it.

6. We will respond to complaints within fifteen (15) business days provided we have all necessary information and have completed any investigation required.

7. In cases where further information, assessment or investigation is required we will agree to reasonable alternative time frames. If we cannot agree, we will treat your complaint as a dispute and we will provide information on how you can have your complaint reviewed by a different employee who has appropriate experience, knowledge and authority.

8. We will keep you informed of the progress of our response to the complaint.

9. When we notify you of our response, we will provide information on how our response can be reviewed by a different employee who has appropriate experience, knowledge and authority.

10. If you tell us you want our response reviewed, we will:

i. treat it as a dispute;

ii. notify you of the name and contact details of the employee assigned to liaise with you in relation to the dispute; and

iii. respond to the dispute within fifteen (15) business days provided we receive all necessary information and have completed any investigation required.

11. In cases where further information, assessment or investigation is required we will agree to reasonable alternative time frames. If we cannot reach agreement you can report your concerns to the Financial Ombudsman Service (FOS).



12. We will keep you informed of the progress of our review of your dispute at least every ten (10) business days.

13. We will respond to your dispute in writing giving:

i. reasons for our decision;

ii. information about how to access available external dispute resolution schemes; and

iii. notification of the time frame within which you must register your dispute with the external dispute resolution scheme.

14. If we are not able to resolve your complaint to your satisfaction within forty-five (45) days (including both the complaint and internal dispute resolution process referred to in this section of the Code), we will inform you of the reasons for the delay and that you may take the complaint or dispute to our External Dispute Resolution scheme even if we are still considering it (and provided the complaint or dispute is within the scheme’s Terms of Reference). We will inform you that you have this right and details of our External Dispute Resolution scheme before the end of the forty-five (45) day period.

15. Chubb subscribes to the independent External Dispute Resolution scheme administered by the FOS. The FOS is available to customers and third parties who fall within the Terms of Reference of FOS.

16. External Dispute Resolution determinations made by FOS are binding upon us in accordance with the Terms of Reference.

17. Where the FOS Terms of Reference do not extend to you or your dispute, we will advise you to seek independent legal advice or give you information about other external dispute resolution options (if any) that may be available to you.

You can contact the FOS in the following ways:

By Phone: 1300 78 08 08

By Mail: GPO Box 3, Melbourne, VIC 3001

Information on the FOS may be obtained from its website at www.fos.org.au

Insurance Council of Australia

Where Chubb cannot provide you with insurance cover, we will refer you to the Insurance Council of Australia (ICA) for information about alternative insurance options (unless you already have someone acting on your behalf).

The ICA has established a dedicated telephone number for consumers who are asking for information about alternative insurance options which is: 1300 884 934.

Additional Information

Who can you talk to?

1. Our contact details are listed below, should you wish to contact us.

2. Your complaint can be submitted to Chubb’s dedicated e-mail address at [email protected]

3. If your complaint is not satisfactorily resolved, you may request that the matter be reviewed by management by writing to:

The Compliance ManagerChubb Insurance Company of Australia LtdLevel 29, 2 Park Street,Sydney NSW 2000

4. Our complaints and disputes procedures follow the requirements of the Code.

Visit www.codeofpractice.com.au for more information about the Code.

About the Insurer

The policy is issued by Chubb Insurance Company of Australia Limited ABN 69 003 710 647 AFSL 239778 of Level 29, 2 Park Street, Sydney NSW 2000. Our Offices:

Brisbane: Level 13, 40 Creek Street, Brisbane, QLD 4000 Ph (07) 3227 5777Postal address: PO Box 1007 Brisbane QLD 4001

Melbourne: Level 14, 330 Collins Street, Melbourne, VIC, 3000Ph: (03) 9242 5111

Perth: Level 1, 225 St. Georges Terrace, Perth, WA, 6000Ph: (08) 6211 7777Postal address: PO Box 7105, Cloisters Square, Perth WA 6850

Sydney:Citigroup Centre, Level 29, 2 Park Street, Sydney, NSW, 2000Ph: (02) 9273 0100

Our Website: www.chubbinsurance.com.au

This PDS is dated 1 June 2014.

Policy Wording



Group Personal Accident & Sickness InsuranceCoverage

Subject to the terms, conditions and exclusions contained in this policy, we will cover insured persons and/or the policyholder for the insurable events described in this policy, provided that:

1. the policyholder has paid or agreed to pay the premium required for this insurance; and

2. the type of cover is specified in the policy schedule as applying to that insured person and/or policyholder.

Cover for each insured person under this policy commences on the insured person’s effective date of coverage.

General Definitions

The following general definitions apply for the purpose of this policy:

Accidentaccident means a single physical event that occurs during the period of insurance and which:

1. is caused by sudden, external and visible means; and

2. results solely, directly and independently of any other cause in a bodily injury that is both unforeseen and unsolicited by an insured person.

Accidental Deathaccidental death means the death of an insured person as a result of an accident.

Bed Care Patientbed care patient means the insured person is necessarily confined to bed outside Australia (provided that such confinement commenced during the period of insurance) for a continuous period of not less than twenty-four (24) hours and the confinement is certified as necessary by a qualified doctor, and under the continuous care of a registered nurse (who is not an insured person or their close relative). Bed care patient does not include the insured person as a patient in any institution used primarily as a nursing or convalescent home, a place of rest, a geriatric ward, a mental institution, a rehabilitation or extended care facility or a place for care or treatment of alcoholics or drug addicts.

Bodily Injurybodily injury means bodily injury resulting solely from an accident and which occurs independently of any illness or any other cause where the bodily injury and accident both occur during the period of insurance and whilst the person is an insured person under the policy.

It does not mean:

1. a sickness; or

2. any pre-existing condition.

Civil Warcivil war means a state of armed opposition, whether declared or not, between two or more parties belonging to the same country where the opposing parties are of different ethnic, religious or ideological groups. Included in the definition is armed rebellion, revolution, sedition, insurrection, civil unrest, coup d’état and the consequences of martial law.

Close Relativeclose relative means the insured person’s spouse or partner, fiancé(e), child, step-child, daughter-in-law, son-in-law, grandchild, parent, step-parent, parent-in-law, grandparent, brother, brother-in-law, half-brother, sister, sister-in-law, half-sister, aunt, uncle, niece or nephew.

Complete fracturecomplete fracture means a fracture in which the bone is broken completely across and no connection is left between the pieces.

Coup d’étatcoup d’état means the overthrow of an existing government by a group of its citizens or subjects.

Dependent Child(ren)dependent child(ren) means the insured person’s and their spouse or partner’s unmarried children (including step or legally adopted children) who are under the age of nineteen (19) years and living with the insured person; or under the age of twenty-five (25) years and a full time student at an accredited institute of higher learning, and who are primarily dependent on the insured person for their maintenance and support.

Dependent children also include an insured person’s unmarried children of any age who are permanently living with the insured person and are mentally or physically incapable of self-support.

Doctordoctor means a doctor or specialist who is registered or licensed to practice medicine under the laws of the country in which they practice, other than:

1. the policyholder;

2. an insured person;

3. a close relative of the insured person; or

4. an employee or director of the policyholder.



Domestic Duties domestic duties means the usual and ordinary domestic duties undertaken by someone as a homemaker and could include childminding, home help services and outdoor household activities.

Effective Date of Coverageeffective date of coverage means the date during the period of insurance on which an insured person first meets the criteria set out for an insured person in the policy schedule.

Employeeemployee means any person in the policyholder’s service including directors (executive or non-executive) and includes consultants, contractors, sub-contractors and/or self-employed persons undertaking work on the policyholder’s behalf.

Event(s)event(s) means the event(s) described in the relevant Table of Events set out in this policy.

ExcessExcess means the amount we will not pay in any one period of insurance per claim and which the insured person is required to bear themselves. The excess amount relevant to each event is specified in the policy schedule and may be excluded from any payment we make.

Excess Periodexcess period means a period of time following an event giving rise to a claim for which no benefits are payable as specified in the policy schedule.

Hairline fracturehairline fracture means mere cracks in the bone.

Incomeincome means the weekly pre-tax income calculated before personal deductions, derived from personal exertion and earned on average by the insured person:

1. over a period of one (1) year immediately before the event; or

2. over the period of employment/self-employment if such period is shorter than one (1) year.

For salaried insured persons, income excludes bonuses, commissions, overtime payments and other allowances.

For total employment cost or salary packaged insured persons, income includes wages, motor vehicle, travel allowances, club subscription fees, housing loan or rental subsidy, clothing or meal allowances but excludes bonuses, commissions and/or overtime payments.

For self-employed insured persons, income is calculated after deduction of all business expenses necessarily incurred in derivation of such income.

Insured Personinsured person means any person shown in the policy schedule as an insured person and/or as nominated by the policyholder and agreed to by us for eligibility under this policy with respect to whom premium has been paid or agreed to be paid.

Limblimb means the entire limb between the shoulder and the wrist or between the hip and the ankle.

Other fractureother fracture means any fracture other than a simple fracture, complete fracture or hairline fracture.

Period of Insuranceperiod of insurance means the period stated in the current policy schedule, as limited by the Operation of Cover stated in the policy schedule or such shorter time if the policy is terminated.

Permanentpermanent means having lasted twelve (12) consecutive months and at the expiry of that time being without hope of improvement.

Permanent Total Disablementpermanent total disablement means total disablement as a result of an accident which continues for twelve (12) consecutive months and at that time is certified by a doctor as being beyond hope of improvement and entirely preventing the insured person forever from engaging in any business, profession, occupation or employment for which he or she is reasonably qualified by training, education or experience.

Policypolicy means this policy wording, the current policy schedule and any other documents we may issue to you that we advise will form part of the policy (e.g. endorsements).

Policy Schedulepolicy schedule means the relevant policy schedule issued by us to the policyholder.

Policyholderpolicyholder means the named organisation or person listed as the policyholder in the policy schedule.



Pre-Existing Conditionpre-existing condition means any illness, disease, syndrome, disability or other condition, including any symptoms or side effects of these:

1. of which the insured person is aware or a reasonable person in the circumstance would be expected to have been aware; or

2. for which the insured person has sought or received medical attention, undergone tests or taken prescribed medication, in the twelve (12) months prior to that insured person‘s effective date of coverage under this policy

Premiumpremium means the premium as shown in the policy schedule that is payable in respect of the policy by the policyholder.

Professional Sportprofessional sport means any sport in which an insured person receives a financial reward, fee, sponsorship or gain as a result of their participation.

Sicknesssickness means any illness, disease or syndrome suffered by the insured person first manifesting itself during the period of insurance and after the insured person’s effective date of coverage, but does not include any pre-existing condition.

Simple fracture

simple fracture means a fracture in which there is a basic and uncomplicated break in the bone and which in the opinion of a doctor requires minimal and uncomplicated medical treatment.

Spouse or Partnerspouse or partner means the insured person’s husband or wife and includes a de-facto and/or life partner of any sex with whom the insured person has continuously cohabited for a period of three (3) months or more.

Specialistspecialist means a doctor recognised for their experience, qualifications and training in a particular branch of medicine or surgery or in the treatment of a specific bodily injury or sickness, to whom the insured person has been referred by another doctor and includes optometrists.

Temporary Partial Disablementtemporary partial disablement means that in the opinion of a doctor, the insured person is temporarily unable to engage in a substantial part of their usual occupation whilst an insured person and under the regular care of and acting in accordance with the instructions or advice of a doctor or specialist.

Temporary Total Disablementtemporary total disablement means that in the opinion of a doctor, the insured person is temporarily unable to engage in any part of their usual occupation whilst an insured person and under the regular care of and acting in accordance with the instructions or advice of a doctor or specialist.

Tooth or Teethtooth or teeth means a sound and natural permanent tooth but does not include first or milk teeth, dentures, implants and dental fillings.

Violent Criminal Actviolent criminal act is an act committed which intentionally threatens, attempts to or actually inflicts physical harm.

Warwar means a state of armed conflict, whether declared or not, between different nations, states, or armed groups using military force to achieve economic, geographic, nationalistic, political, racial, religious or other ends.

We / Our / Uswe / our / us means Chubb Insurance Company of Australia Limited ABN 69 003 710 647 AFSL 239778 who is the insurer and issuer of this policy.

Work Experiencework experience is a set period of time during which a young person, usually a student, works either voluntarily or for a very small monetary amount for the policyholder in order to gain experience in a particular type of industry.

You / Youryou / your means the policyholder listed in the policy schedule.



Personal Accident & Sickness CoverPersonal AccidentIn the event an insured person suffers bodily injury as a direct result of an accident, we will pay corresponding amounts shown in the Table of Events below where:

1. the bodily injury occurs within 12 months of the accident;

2. the bodily injury occurs after the insured person’s effective date of coverage; and

3. both the accident and the bodily injury occur during the period of insurance.

SicknessWhen Part C – Weekly Sickness Benefit is specified in the policy schedule, we will pay the corresponding amounts shown in the Table of Events below, in the event an insured person suffers sickness, after the insured person’s effective date of coverage.

Table of EventsPart A – Accidental Death and DisablementCover for an event under this Part applies only if an amount is shown in the policy schedule against Part A – Accidental Death and Disablement.

The Events The following event(s) must occur within 12 months of the date of the accident.

Benefit Amounts The amounts shown below are a percentage of the amount shown in Part A - Accidental Death and Disablement in the policy schedule

1. Accidental Death 100%

2. Permanent Total Disablement 100%

3. Permanent Paraplegia or Quadriplegia

100%

4. Permanent and incurable paralysis of all limbs

100%

5. Permanent Total loss of sight of one or both eyes

100%

6. Permanent Total loss of use of one or more limbs

100%

7. Permanent and incurable insanity

100%



8. Permanent Total loss of the lens of:(a) both eyes(b) one eye

100%60%

9. Permanent Total loss of hearing of:(a) both ears(b) one ear

80%30%

10. Burns:(a) third degree burns and/

or resultant disfigurement which covers more than twenty percent 20% of the entire external body

(b) second degree burns and/or resultant disfigurement which covers more than twenty percent 20% of the entire external body

50%

25%

11. Permanent Total loss of use of four fingers and thumb of either hand

80%

12. Permanent Total loss of use of four fingers of either hand

50%

13. Permanent Total loss of use of the thumb of either hand:(a) both joints(b) one joint

40%20%

14. Permanent Total loss of use of fingers of either hand:(a) three joints(b) two joints(c) one joint

15%10%5%





15. Permanent Total loss of use of toes of either foot:

(a) all – one foot(b) great - both joints(c) great - one joint(d) other than great - each

toe

15%5%3%1%

16. Fractured leg or kneecap with established non-union

10%

17. Loss of at least fifty percent (50%) of all sound and natural teeth, including capped or crowned teeth, but excluding first teeth and dentures

1% to a maximum of $10,000 in total

18. Shortening of leg by at least five centimetres (5 cm)

7.5%

19. Permanent Partial Disablement not otherwise provided for under events 8 to 18.

Such percentage of the amount shown in Part A – Accidental Death and Disablement in the policy schedule as we at our absolute discretion determine being not inconsistent with the Benefit Amount provided under events 8 to 18.The maximum amount payable under event 19 (Permanent Partial Disablement) is fifty thousand dollars ($50,000).

Part B – Weekly Injury BenefitCover for an event under this Part applies only if an amount is shown in the policy schedule against Part B - Weekly Injury Benefit.

The Events

20. Temporary Total Disablement

Where an insured person suffers temporary total disablement as a result of a bodily injury and where that temporary total disablement persists, after the excess period, we will pay up to the amounts shown in the policy schedule against Part B - Weekly Injury Benefit, but not exceeding the percentage of income shown in the schedule for that insured person.

21. Temporary Partial Disablement

Where an insured person suffers temporary partial disablement as a result of a bodily injury and where that temporary partial disablement persists, after the excess period, we will pay up to the amounts shown in the policy schedule against Part B - Weekly Injury Benefit, less any amount of current earnings as a result of working in a reduced capacity with the policyholder, but not exceeding the percentage of income shown in the policy schedule for that insured person.

Should the insured person be able to return to work with the policyholder in a reduced capacity, but elect not to do so then the benefit payable will be 25% of Event 20 - Temporary Total Disablement.



Part D - Fractured Bones Cover for an event under this Part applies only if an amount is shown in the policy schedule against Part D - Fractured Bones


Benefit Amounts The amounts shown are a percentage of the amount shown in Part D – Fractured Bones as shown in the policy schedule

24. Neck, skull or spine (complete fracture)

100%

25. Hip 75%

26. Jaw, pelvis, leg, ankle or knee (complete fracture)

50%

27. Cheekbone, shoulder or simple, hairline or other fracture of neck, skull or spine

30%

28. Arm, elbow, wrist or ribs (complete fracture)

25%

29. Jaw, pelvis, leg, ankle or knee (simple, hairline or other fracture)

20%

30. Nose or collar bone 20%

31. Arm, elbow, wrist or ribs (simple, hairline or other fracture)

10%

32. Finger, Thumb, Foot, Hand or Toe

7.5%

Part C – Weekly Sickness BenefitCover for an event under this Part applies only if an amount is shown in the policy schedule against Part C - Weekly Sickness Benefit.

The Events

22. Temporary Total Disablement

Where an insured person suffers temporary total disablement as a result of a sickness and where that temporary total disablement persists, after the excess period, we will pay up to the amounts shown in the policy schedule against Part C - Weekly Sickness Benefit, but not exceeding the percentage of income shown in the schedule for that insured person.

23. Temporary Partial Disablement

Where an insured person suffers temporary partial disablement as a result of a sickness and where that temporary partial disablement persists, after the excess period, we will pay up to the amounts shown in the policy schedule against Part C - Weekly Sickness Benefit, less any amount of current earnings as a result of working in a reduced capacity with the policyholder, but not exceeding the percentage of income shown in the policy schedule for that insured person.

Should the insured person be able to return to work with the policyholder in a reduced capacity, but elect not to do so then the benefit payable will be 25% of Event 20 - Temporary Total Disablement.



Part E - Injury Resulting in Surgery Outside AustraliaCover for an event under this Part applies only if an amount is shown in the policy schedule against Part E - Injury Resulting in Surgery. The surgery must be undertaken outside Australia and must be carried out within 12 months of the date of the accident. Any payment made will be subject to proof of surgery being undertaken.


Benefit Amounts The amounts shown are a percentage of the amount shown in Part E - Injury Resulting in Surgery as shown in the policy schedule

33. Craniotomy 100%

34. Amputation of a limb 100%

35. Fracture of a limb requiring open reduction

50%

36. Dislocation of a joint requiring open reduction

25%

37. Any other surgical procedure carried out under a general anaesthetic

5%

Part F - Sickness Resulting in Surgery Outside AustraliaCover for an event under this Part applies only if an amount is shown in the policy schedule against Part F - Sickness Resulting in Surgery. The surgery must be undertaken outside Australia and must be carried out within 12 months of the date the insured person first becomes aware of the sickness. Any payment made will be subject to proof of surgery being undertaken.

The Events The following event(s) must occur within 12 months of the date of the sickness.

Benefit Amounts The amounts shown are a percentage of the amount shown in Part F - Sickness Resulting in Surgery as shown in the policy schedule

38. Open heart surgical procedure 100%

39. Brain surgery 100%

40. Abdominal surgery carried out under general anaesthetic

50%

41. Any other surgical procedure carried out under a general anaesthetic

5%

Part G - Injury Resulting in Loss or Damage to TeethCover for an event under this Part applies only if an amount is shown in the policy schedule against Part G – Injury Resulting in Loss or Damage to Teeth.

The benefit payable under this Part shall be limited to a maximum of two thousand dollars ($2,000) for any one accident causing bodily injury which results in loss or damage to teeth.


Benefit Amounts The amounts shown are a percentage of the amount shown in Part G - Injury Resulting In Loss or Damage to Teeth as shown in the policy schedule

42. Loss of teeth per tooth 100%

43. Chipped or broken teeth, per tooth

50%



Lifestyle Protection BenefitsAccidental H.I.V. Infection BenefitIf an insured person accidentally contracts the Human Immunodeficiency Virus (H.I.V.) infection:

1. as a direct result of bodily injury caused by a violent and physical bodily assault by another person on the insured person during the period of insurance and whilst they are an insured person; or

2. as a direct result of receiving medical treatment provided by a doctor for an insured person’s bodily injury or sickness while they are insured under this policy;

we will pay the insured person up to the amount stated in the policy schedule against Lifestyle Protection Benefits - Accidental H.I.V. Infection Benefit, provided that:

1. there is a positive diagnosis within 180 days of the event giving rise to the H.I.V. infection;

2. any event leading to or likely to lead to a positive diagnosis of H.I.V. is reported to us and medical tests are carried out by a doctor no more than forty-eight (48) hours from the date and time of the event giving rise to the H.I.V. infection; and

3. a recognised laboratory carries out medical and clinical tests that conclusively prove that the insured person was not H.I.V. positive at the time and date immediately before the event giving rise to the H.I.V. infection. No benefit will be payable if you or the insured person fails to comply with or to provide the required level of proof.

Accommodation and Transport ExpensesIf an insured person sustains a bodily injury and is admitted as an in-patient of a hospital, which is more than 100 kilometres from the insured person’s normal place of residence, we will pay the actual and reasonable transport and/or accommodation expenses incurred by their spouse or partner and/ or dependent children to travel to or remain with the insured person up to the amount shown in the policy schedule against Lifestyle Protection Benefits – Accommodation and Transport Expenses subject to any restriction to do so.

Advanced PaymentIf an insured person sustains a bodily injury or sickness for which benefits are payable under Events 20 or 22, provided that medical evidence is presented from a doctor or specialist certifying that the total period of temporary total disablement will be a minimum of twenty-six (26) continuous weeks, we will pay at the time of first payment twelve (12) weeks benefit.

Bed Care BenefitIf an insured person sustains a bodily injury for which benefits are payable under the Table of Events and becomes a bed care patient outside Australia, we will pay up to the amount stated in the policy schedule against Lifestyle Protection Benefits – Bed Care Benefit for each week that an insured person remains a bed care patient beginning with the second day of confinement. A daily rate of one seventh (1/7th) of the weekly Bed Care Benefit will be paid where an insured person remains a bed care patient for less than seven (7) days.

Coma BenefitIf an insured person sustains a bodily injury which directly causes or results in the insured person being in a state of continuous unconsciousness and the insured person or their legal representative provide us with a doctor’s certificate that verifies that the direct cause of the continuous unconsciousness was the bodily injury, we will pay the insured person or the insured person’s spouse or partner or their legal representative up to the amount stated in the policy schedule against Lifestyle Protection Benefits - Coma Benefit for each week that an insured person remains in a state of continuous unconsciousness, subject to the maximum number of weeks stated in the policy schedule.

Dependent Child SupplementIf an insured person suffers bodily injury which results in accidental death, we will pay to the insured person’s spouse or partner or legal personal representative of the insured person’s estate, the amount stated in the policy schedule against Lifestyle Protection Benefits – Dependent Child Supplement, subject to the maximum benefit amount per family as stated in the policy schedule.

Domestic Help BenefitIf an insured person sustains a bodily injury and a doctor certifies that the insured person is unable to carry out domestic duties, we will pay the actual and reasonable costs incurred of hiring domestic help up to the amount stated in the policy schedule against Lifestyle Protection Benefits –Domestic Help Benefit, provided that the domestic help is not carried out by the insured person’s close relatives nor a person permanently residing with the insured person.

Education Fund BenefitIf an insured person suffers accidental death, we will pay up to the amount stated in the policy schedule against Lifestyle Protection Benefits - Education Fund Benefit on behalf of each surviving dependent child per claim to each dependent child’s school or university for fees incurred.



Escalation of Claim BenefitSubject to renewal of this policy and payment of the premium, after payment of a benefit under Events 20, 21, 22 or 23 continuously for twelve (12) months and again after each subsequent period of twelve months during which a benefit is paid, the benefit will be increased by a compound rate of 5% per annum.

Funeral Expenses BenefitIf an insured person suffers accidental death, we will reimburse the reasonable expenses incurred up to the amount stated in the policy schedule against Lifestyle Protection Benefits - Funeral Expenses Benefit for the insured person’s funeral, burial or cremation or the cost of returning the insured person’s body or ashes to a place nominated by the insured person’s spouse or partner or the legal representative of the insured person’s estate.

Independent Financial Advice Benefit Following payment of a Benefit Amount under Events 1 to 8(a), we will reimburse the insured person or the insured person’s spouse or partner or estate up to the maximum amount stated in the policy schedule against Lifestyle Protection Benefits - Independent Financial Advice Benefit for professional financial planning advice provided by a qualified financial planner within six (6) months after the date of the event.

Modification BenefitIf an insured person sustains a bodily injury for which a benefit is paid under Events 2 or 3, we will pay up to the amount stated in the policy schedule for costs necessarily incurred to modify the insured person’s home and/or motor vehicle, and/or costs associated with relocating the insured person to a more suitable home, provided that medical evidence is given to us from a doctor certifying the modification and/or relocation is necessary.

Orphan BenefitIf an insured person and their spouse or partner suffer accidental death as a result of the same accident, we will pay to the insured person’s estate or the guardian of the dependent children a lump sum benefit for each surviving dependent child subject to a maximum benefit amount per family as stated in the policy schedule against Lifestyle Protection Benefits – Orphan Benefit.

Out of Pocket ExpensesIf an insured person sustains a bodily injury which directly results in otherwise unforeseeable expenses for clothing, medical aids (not including electronic devices) and local transportation for the purpose of seeking medical treatment, we will pay the actual and reasonable costs incurred up to the maximum amount shown in the policy schedule against Lifestyle Protection Benefits – Out Of Pocket Expenses, provided that those costs are not insured elsewhere under this policy, or otherwise applicable to an expense for which a Medicare benefit is payable.

Premature Birth/Miscarriage BenefitIf an insured person sustains a bodily injury which results in premature childbirth (prior to 26 weeks gestation) or miscarriage, we will pay the insured person the lump sum benefit amount shown in the policy schedule against Lifestyle Protection Benefits – Premature Birth/Miscarriage Benefit.

Rehabilitation BenefitIf an insured person sustains a bodily injury for which a benefit is paid under Events 2, 20 or 21, we will pay up to the amount stated in the policy schedule against Lifestyle Protection Benefits – Rehabilitation Benefit for costs necessarily incurred for tuition or advice for the insured person from a licensed vocational school, provided such tuition or advice is undertaken with our prior written agreement and that medical evidence is presented from a doctor or specialist certifying the tuition or advice is necessary.

Spouse or Partner Employment Training BenefitIf an insured person sustains a bodily injury which results in accidental death or permanent total disablement, we will reimburse an insured person’s spouse or partner up to the benefit amount shown in the policy schedule against Lifestyle Protection Benefits – Spouse or Partner Employment Training Benefit for the actual costs incurred for training or retraining the insured person’s spouse or partner:

1. for the sole purpose of obtaining gainful employment; or

2. to improve their potential for employment; and/or

3. to enable them to improve the quality of care they can provide to the insured person,

provided that:

1. the spouse or partner has not attained the age of sixty-five (65) years of age at the commencement of the training; and

2. the training is provided by a recognised institution with qualified skills to provide such training.

This benefit is payable in addition to any other applicable Benefit Amount payable under this policy and only applies if the spouse or partner incurs Employment Training Expenses within twenty – four (24) months following the date of the insured person’s bodily injury resulting in accidental death or permanent total disablement.



Student Tutorial BenefitIf an insured person is a registered full time student and sustains a bodily injury and a doctor certifies that the insured person is unable to attend classes, we will pay the actual costs incurred of home tutorial services to the maximum amount shown in the policy schedule against Lifestyle Protection Benefits - Student Tutorial Expenses provided that the tutorial service is not carried out by the insured person’s close relatives nor a person permanently residing with the insured person.

Unexpired Membership BenefitIf an insured person suffers a bodily injury which results in a benefit being paid under:

1. Part A – Accidental Death and Disablement Events 2 to 8(a); or

2. Events 20 and/or 21 for which a doctor or specialist certifies in writing will continue for a minimum period of twenty-six (26) weeks;

and it is certified by a doctor or specialist as preventing the insured person from continuing their participation in any sport or gym activity for which they have pre- paid a membership, association or registration fee, we will pay the insured person a pro-rata refund of such fees paid for the current season up to an aggregate amount as shown in the policy schedule against Lifestyle Protection Benefits - Unexpired Membership Benefit.



Corporate Protection BenefitsChauffeur BenefitIf an insured person sustains a bodily injury for which a benefit is paid under Event 20 or 22, provided that medical evidence is presented to us from a doctor or specialist certifying that the insured person is unable to operate a motor vehicle or travel on other available modes of public transport, we will pay up to the amount stated in the policy schedule against Corporate Protection Benefits - Chauffeur Benefit. The amount we agree to pay will be the reasonable costs incurred for the hire of a suitable chauffeured vehicle or taxi to transport the insured person directly to and from their normal place of residence and normal place of work.

Childcare BenefitIf an insured person sustains a bodily injury for which a benefit is paid under Events 2 to 8(a), we will pay the insured person the actual and reasonable expenses necessarily incurred for the services of a registered childcare provider up to the amount stated in the policy schedule against Corporate Protection Benefits - Childcare Benefit, but only in respect of additional costs that would not otherwise have been incurred.

Corporate Image ProtectionIf an insured person sustains a bodily injury which results in accidental death or permanent total disablement, we will pay the policyholder the actual and reasonable expenses necessarily incurred for the services of image/public relations consultants for the purpose of protecting the policyholder’s corporate image, up to the amount stated in the policy schedule against Corporate Protection Benefits - Corporate Image Protection.

DisappearanceIf the body of an insured person is not found within twelve (12) months after an accident involving the conveyance in which they were travelling, accidental death will be presumed in the absence of any evidence to the contrary. The accidental death benefit amount set out in the Table of Events in Part A - Accidental Death and Disablement, Event 1 shall become payable, subject to a signed undertaking by the beneficiary that if the insured person is subsequently found alive, such accidental death benefit amount will be refunded to us.

Replacement Staff / Recruitment CostsIf an insured person sustains a bodily injury and in our judgement we believe that a benefit will be paid under Part A - Accidental Death and Disablement, Event 1 or 2, we will pay the actual and reasonable costs incurred by the policyholder for the recruitment of replacement employees, up to the amount stated in the policy schedule against Corporate Protection Benefits - Replacement Staff/Recruitment Costs, provided that the costs are incurred within sixty (60) days and be crucial and necessary for the policyholder’s business to continue. The policyholder must first provide a signed undertaking that any amount paid to the policyholder will be

repaid to us if it is found that a valid claim did not or will not eventuate.

Visitors BenefitIf a third party visits the policyholder’s premises during the period of insurance in a business capacity and sustains a bodily injury which, had the visitor been an insured person, would have resulted in a benefit being paid under Events 1 or 2, we will pay the policyholder the amount shown in the policy schedule against Corporate Protection Benefits - Visitors Benefit.

Work Experience BenefitIf a person is undertaking authorised work experience with the policyholder and, whilst performing occupational duties on behalf of the policyholder sustains a bodily injury which, had the person been an insured person, would have resulted in a benefit being paid under Events 1 to 9, we will pay the policyholder the amount shown in the policy schedule against Corporate Protection Benefits - Work Experience Benefit.

Workplace Assault BenefitIf an insured person sustains a bodily injury as a result of an unprovoked assault at their usual place of employment or whilst in the course of their duties on behalf of the policyholder, we will pay the insured person the amount shown in the policy schedule against Corporate Protection Benefits - Workplace Assault Benefit.

Workplace Trauma BenefitIf an insured person witnesses a violent criminal act whilst at their usual place of employment and does not sustain a bodily injury we will pay the insured person the amount shown in the policy schedule against Corporate Protection Benefits - Workplace Trauma Benefit.



General Conditions Applicable to this Policy

1. Any Benefit Amounts payable for Events 1 to 19 will be paid in addition to any benefit already paid for under Events 20 and 21 in respect of the same bodily injury.

2. After the occurrence of any of the Events 2 to 8(a) all cover with respect to that insured person under Part A will cease.

3. If as a result of bodily injury, the insured person is entitled to any benefit under Events 20 and/ or 21 or Events 22 and/or 23 and subsequently becomes entitled to a Benefit Amount under the Table of Events for Event 2 or 3, all benefits payable for Events 20 and/or 21 or Events 22 and/or 23 will cease from the date of such entitlement.

4. Where an insured person claims benefits in respect of Events 20 and/or 21 or Events 22 and/or 23, the insured person agrees upon our written request to:

i. participate and co-operate with us in establishing and following a plan comprising activities and procedures for the purpose of achieving or expediting their return (either in full or in substantial part) to their usual occupation;

ii. provide us with any medical reports that are relevant to Events 20 and/or 21 or Events 22 and/or 23 or relevant to a plan to achieve or expedite their return to their usual occupation;

iii. consent to their treating doctors, their employer, us or service providers that we nominate associating with each other or exchanging information for the purpose of achieving or expediting their return to their usual occupation; and

iv. undertake reasonable medical investigations or attend medical examinations as requested by us.

5. No benefit will be payable for Events 20 and/ or 21 or Events 22 and/or 23 in respect of any one bodily injury or sickness or disease at all unless the insured person shall as soon as possible after the happening of a bodily injury or sickness or disease giving rise to a claim, procure and follow proper medical advice from a doctor.

6. The amount of the benefits payable for Events 20 and/or 21 or Events 22 and/or 23 as set out in the policy schedule will be paid monthly in arrears. Any benefits payable for a period of less than one week will be paid at a rate of one-seventh (1/7th) of the weekly benefit for each day during which disablement continues.

7. If a claim occurs for an insured person under Events 20 and/or 21 or Events 22 and/or 23 as a result of bodily injury or sickness, and whilst during the period of

insurance the insured person suffers from the same or an associated cause or causes, the subsequent period of disablement will be deemed a continuation of the prior period unless, between such periods, the insured person has worked on a full-time basis for at least six (6) consecutive months, in which case the subsequent period of disablement will be deemed to have resulted from a new bodily injury or sickness and a new excess period will apply.

8. The Benefit Amounts payable under Events 20 and/or 21 or Events 22 and/or 23 will be reduced by:

i. the amount of any periodic compensation paid under any workers’ compensation legislation or transport accident legislation or any legislation having a similar effect; and

ii. the amount of any sick leave paid or, at the discretion of the policyholder, sick leave entitlement;

so as to limit the total of all such benefits and entitlements to the lesser of the insured person’s income or the Benefit Amount shown in the policy schedule.

9. In respect of insured persons who have attained the age of sixty-five (65) years, the benefit payable for Event 1 and Events 3 to 19 will be limited to twenty percent (20%) of the Benefit Amount shown in the Table of Events to a maximum of one hundred thousand dollars ($100,000) unless otherwise agreed to by us in writing.

10. If the Benefit payable with respect to Events 1 to 19 is salary linked, the actual Benefit payable for an insured person who is not in receipt of a salary will be limited to the lesser of the maximum sum insured stated in the policy schedule or $250,000.

11. The benefit payable to insured persons under 18 years of age for Event 1 (Accidental Death) will be 10% of the sum insured stated in the policy schedule or $25,000, whichever is the lesser, and with respect to Events 2 to 19, the Benefit will be limited to the lesser of the sum insured stated in the policy schedule or $250,000, unless otherwise specified.



General Provisions Applicable to this PolicyAggregate Limit of LiabilityExcept as provided below, our total liability for all claims arising under the policy in respect of any one accident or series of accidents arising out of any one occurrence during the period of insurance, shall not exceed the amount shown in the policy schedule against Aggregate Limit of Liability Any One Accident or Occurrence.

Our total liability for all claims arising under the policy in respect of any one accident or series of accidents arising out of any one occurrence during the period of insurance, relating to air travel in aircrafts whose flights are not conducted in accordance with fixed schedules to and from fixed terminals over specific routes, shall not exceed the amount shown in the policy schedule against Aggregate Limit of Liability Non-Scheduled Air Travel.

Alteration of RiskYou must tell us as soon as possible if circumstances occur, or if changes or alterations are intended or made which increase the risk of damage, injury, liability, loss or sickness.

Assignment and Beneficiary ChangeNo assignment of interest under this policy will be binding on us unless and until the original or a duplicate thereof is filed with us. We assume no responsibility for the validity of an assignment. No beneficiary change under this policy will bind us unless we receive written notice of such change.

Automatic Additions and DeletionsThe policyholder must declare to us any insured persons who are required to be covered under the policy during the period of insurance within thirty (30) days from their effective date of coverage. Cover will be subject to a pro-rata premium for time on risk, which can be paid on a quarterly or annual basis. The policyholder must also declare to us any insured persons who no longer require cover under the policy within thirty (30) days from their date of cessation. Note the maximum pro-rata premium applicable for insured persons that no longer require cover under the policy who may be entitled to a pro-rata refund will be limited to 90 days. However we will not refund any premium if we have paid a claim or benefit to you or an insured person under the policy.

CancellationThe policyholder may cancel this policy at any time by notifying us in writing. The cancellation will take effect from 4:00 pm on the day we receive the policyholder’s written notice of cancellation or such time as may be otherwise agreed.

We may cancel the policy or any Part thereof, for any of the reasons set out in Section 60 of the Insurance Contracts Act 1984 (Cth) and in accordance with Section 59 of the Insurance Contracts Act 1984 (Cth).

If the policy is cancelled by either the policyholder or us, we will refund the premium for the policy less a pro-rata proportion of the premium to cover the period for which insurance applied. However we will not refund any premium if we have paid a claim or benefit to you or an insured person under the policy.

Cover in respect to an insured person will end on the earlier of:

1. the date the insured person no longer meets the criteria for an insured person set out in the policy schedule;

2. the end of the period of insurance; or

3. when this policy is cancelled by you at your request or by us pursuant to the Insurance Contracts Act 1984 (Cth).

CurrencyAll amounts shown are in Australian dollars. If expenses are incurred in a foreign currency, then the rate of currency exchange used to calculate the amount to be paid will be the rate of exchange published in the Australian Financial Review on the date the expense is incurred or loss is sustained. All claims will be paid in Australian dollars.

Entire Contract/AlterationThis policy will not be modified except by written amendment or endorsement attached hereto and signed by our Authorised Employee.

ExposureWhere an insured person is exposed to the elements as a result of an accident and suffers from any of the events stated in the Table of Events as a direct result of that exposure within twelve (12) months of the accident, the insured person will be deemed for the purposes of this policy to have suffered a bodily injury on the date of the accident.

Proper Law and JurisdictionThe construction, interpretation and meaning of the provisions of this policy will be determined in accordance with Australian Law. In the event of any dispute arising under this policy, including but not limited to its construction, validity, performance and/ or interpretation, the policyholder and/or insured person will submit to the exclusive jurisdiction of any competent court in the Commonwealth of Australia.

Medical Examination or Post MortemAt our expense, we will be entitled to have any insured person medically examined or in the event of death, a post mortem examination carried out. We will give the insured person or their legal representative fair and reasonable notice of the medical examination.

Other InsuranceIn the event of a claim, the policyholder and/or insured person must advise us as to any other insurance policies that may be available to pay or partially pay that claim.



PrecautionsThe policyholder and/or insured person must take all reasonable care to prevent or minimise damage, injury, liability, loss, accident or sickness, including complying with any law, by-law, ordinance or regulation that concerns the safety of persons or property.

Providing ProofsThe insured person must keep documents they will need in case of a claim. These documents may include documents to substantiate the insured person’s earnings and any medical certificates or reports that relate to any claim.

SubrogationIf we make any payment under this policy, then to the extent of that payment, we may exercise any rights of recovery held by the policyholder or the insured person. The policyholder and the insured person must not do anything which reduces any such rights and must provide reasonable assistance to us in pursuing any such rights.



General Exclusions Applicable to this PolicyWe will not pay benefits, loss, costs or expense arising out of any:

1. claim for more than one of the Events 1 to 19 in respect of the same bodily injury;

2. claim for Events 20 and/or 21 or Events 22 and/or 23 in excess of the total number of weeks stated in the policy schedule in respect of any one bodily injury or sickness or disease except for insured persons who have attained the age of sixty-five (65) years where the total Benefit Period is limited to a maximum of 52 weeks unless otherwise stated in the policy schedule;

3. claim for Event 2, permanent total disablement for insured persons who have attained the age of sixty-five (65) years unless otherwise stated in the policy schedule;

4. claim for more than one Benefit for Events 20 and/or 21 or Events 22 and/or 23 that occur at the same period of time;

5. claim for Events 20 and/or 21 or Events 22 and/ or 23 with respect to any sickness or disease which is in any way attributable to childbirth or pregnancy with the exception of any unexpected and unforeseen medical complications or emergencies arising there from;

6. radioactivity, or the use, existence or escape of any nuclear fuel, nuclear material or nuclear waste;

7. cosmetic, elective or plastic surgery, (except and to the extent that it is necessary for the cure or alleviation of bodily injury to or sickness suffered by the insured person);

8. pre-existing condition prior to the policy being purchased or any condition that has been aggravated during the period of insurance and/or degenerative condition unless that pre-existing condition has been accepted by us in writing;

9. claim that would result in us contravening any workers compensation legislation and or transport accident legislation;

10. claim where the policyholder or the insured person and/or their representatives refused to follow our instructions and directions;

11. claim where, at the time of the incident, the insured person was the driver of a vehicle or substitute vehicle and:

i. did not hold a current, valid licence or was cancelled, disqualified or suspended from driving; or

ii. did not hold the appropriate class of licence for that vehicle;

12. claim by any insured person who has attained the age of seventy-five (75) years. This will not prejudice any entitlement to claim benefits which have arisen or occurred before an insured person attained the age of seventy-five (75) years;

13. insured person engaging in or taking part in:

i. flying in an aircraft or aerial device other than as a passenger in any aircraft licensed to carry passengers; or

ii. training for or participating in professional sport of any kind;

14. intentional self-inflicted bodily injury, suicide or any illegal or criminal act committed by the policyholder or an insured person;

15. war, civil war, invasion, act of foreign enemy, rebellion, revolution, insurrection or military or usurped power;

16. claim to the extent that trade or economic sanctions or other laws or regulations prohibit the Insurer, its parent company or its ultimate controlling entity from providing the insurance;

17. claim with respect to any statutory compulsory third party insurance equivalent regimes nor any workers compensation insurance schemes to the extent that cover may otherwise overlap with such regimes or schemes in any Australian state or territory; or

18. claim where the payment of any benefit or amount would be in contravention of any Medicare or private health insurance laws or regulations in Australia including the Health Insurance Act 1973 (Cth), National Health Act 1953 (Cth), Private Health Insurance Act 2007 (Cth) and Private Health Insurance (Health Insurance Business) Rules 2010, the Medicare Australia Act 1973 or any successor or amending legislation.



How to Make a ClaimIf you wish to make a claim the contact details are as follows:

E-mail: [email protected]: PO Box 20336, World Square PO, NSW, 2002

Notice of ClaimReport Within 30 Days of LossAny occurrence or loss which may give rise to a claim under this policy should be reported to us in writing within thirty (30) days or in any event, as soon as reasonably possible after the occurrence or loss. Failure to furnish us with notice within the time provided in the policy will not invalidate any claim but a failure to do so may result in us being prejudiced and may reduce our liability under the policy.

Proof of LossWritten proof of loss must be given to us as soon as possible and, in any event, within thirty (30) days after we receive notice of your claim together with original copies of all relevant documentation. You or the insured person will, at your or their expense, provide us with such certificates, information and evidence as we may from time to time require, in a form prescribed by us.

Physical Examination and AutopsyProvided that we give reasonable notice, we will be allowed to have any insured person medically examined or, in the event of an insured person’s death, a post mortem examination carried out at our expense.

Claims InvestigationIn the event of a claim, we may make any investigation we deem necessary, and both you and the insured person will cooperate fully with such investigation. Failure by you or the insured person to cooperate with our investigation may result in denial of the claim or cancellation of the policy.

Payment of ClaimThe benefit for Part A, Event 1 will be paid to you or as you direct. Unless otherwise specified in the policy, all other benefits will be payable to the insured person or as they direct. All such payments will be a discharge to us with respect to all claims under your policy.

Fraudulent ClaimsIf any claim under this policy is fraudulent in any respect, or if any fraudulent means or devices are used by you, the insured person, or anyone acting on your or the insured person’s behalf to obtain benefits under this policy, we may, subject to law reduce our liability in respect of such claim or may refuse to pay the claim in whole or in part.

Processing and Payment of ClaimsSubject to payment of the premium, we will take all reasonable steps to pay a valid claim promptly.

Making Claims After Your Policy is CancelledIf your policy is cancelled effective from a particular date, this does not affect your rights to make a claim under your policy if the event occurred before the date that the cancellation became effective.

Commitment to ServiceChubb’s Internal Dispute Resolution Process is evidence of Chubb’s commitment to service. Chubb has established an Internal Dispute Resolution Panel to handle any unresolved complaints. It underscores Chubb’s commitment to acting fairly and honestly with its customers.

If you are not satisfied with any aspect of the service that you receive in relation to the Group Personal Accident & Sickness Policy we would appreciate you letting us know.

Our website can be visited at www.chubbinsurance.com.au or you can contact us on Ph (02) 9273 0100 | Fax (02) 9273 0101

group personal accident & sickness insurance · accident & sickness policy include: •...

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